Device for treatment of pulmonary diseases



April 2, I933 Filed Feb. 13, 1956 H. w. SEELER 3,083,797

DEVICE FOR TREATMENT OF PULMONARY DISEASES 2 Sheets-Sheet l 12 156 W ILI 1 17 --I '78 22 g INVENTOR.

H/S ATTOENEYS LN w JIEZ 21-15.]

April 2, 1963 H. w. SEELER DEVICE FOR TREATMENT OF PULMONARY DISEASESFiled Feb. 13, 1956 2 Sheets-Sheet 2 INVENTOR. HENZV W SE'ELEE HIS flTTOF/VEYS' 3,083,707 Patented Apr. 2, 1963 3,083,707 DEVICE FORTREATMENT OF PULMONARY DISEASES Henry W. Sealer, 3142 Atherton Road,Dayton 9, Ghio Filed Feb. 13, 1956, Ser. No. 565,015 11 Claims. (Cl.128-29) This invention relates to a device for treatment of pulmonarydiseases and more particularly to a breathing apparatus for supplying avaporized medicament to the lungs of a patient, although not necessarilyso limited.

The breathing apparatus to which this invention pertains is essentiallya pressure control apparatus which periodically interrupts a flow of gasunder pressure to the lungs of a patient. As the patient attempts toinhale, the control mechanism operates automatically to allow the gas toflow into the patients lungs as an aid to inhalation. When the gaspressure in the lungs reaches a preselected maximum value, the controlmechanism operates automatically to cut oil the supply of gas permittingthe gas pressure in the lungs to drop to atmospheric pressure, thepatient exhaling naturally.

One object of this invention is to provide a breathing apparatusoperable from a low pressure source of breathing gas. The source may be.for example, an electrically or manually operated air compressor. A gaspressure of 35 mm. mercury is sufficient to operate the breathingapparatus, hence, the need for costly cylinders of highly compressedoxygen or the like is eliminated.

Another object of this invention is to provide, in combination with thebreathing apparatus, a medicament nebulizer assembly, the operation ofwhich is governed by the breathing apparatus. As a means for conservingmedicament, the nebulizer assembly in this combination is operative onlyduring the inhalation cycle of the breathing apparatus so thatmedicament is never released to the atmosphere until it has passed intothe lungs of a patient undergoing treatment.

Still another object of this invention is to provide a novel valveassembly in combination with the breathing apparatus which permitsexhalation of gas directly into the ambient atmosphere, by-passing thebreathing apparatus. Contamination of the breathing apparatus parts withexhaled medicament is thus prevented. As a further consequence, thebreathing apparatus is able to provide fresh gas for inhalationimmediately upon initiation of the inhalation cycle, with no recyclingof exhaled air.

Other objects and advantages reside in the construction of parts, thecombination thereof and the mode of operation. as will become moreapparent from the following description.

In the drawings, FIGURE 1 is a perspective view of the pulmonarytreatment device including the medicament nebulizer assembly.

FIGURE 2 is an enlarged sectional view taken substantially along theline 22 of FIGURE 1.

FIGURE 3 is an enlarged sectional view taken substantially along theline 3-3 of FIGURE 1.

FIGURE 4 is a sectional view taken substantially along the line 44 ofFIGURE 2.

FIGURE 5 is an elevational view oriented 90, of the portion of thepulmonary treatment device shown in FIGURE 4, with parts in sectiontaken substantially along the line 5-5 of FIGURE 4.

FIGURE 6 is an elevational view of the portion of the pulmonarytreatment device shown in FIGURE 4, with parts in section takensubstantially along the line 6-6 of FIGURE 4.

FIGURE 7 is a sectional view taken substantially along the line 77 ofFIGURE 2.

FIGURE 8 is an end elevational view of the portion of the pulmonarytreatment device shown in FIGURE 3 with parts in section takensubstantially along the line 8-8 of FIGURE 1.

FIGURE 9 is a sectional view taken substantially along the line 9-9 ofFIGURE 2.

FIGURE 10 is an enlarged sectional view taken substantially along theline Iii-10 of FIGURE 1.

Referring to the drawings in detail, FIGURE 1 shows the generalarrangement of the elements of the pulmonary treatment device. Thereference numeral 20 indicates a pressure regulator apparatus adapted toreceiver gas from a source of gas under pressure (not shown). Connectedto the pressure regulator apparatus 20 by means of a herdble conduit orhose 22 is a housing 24 for an exhalation valve assembly which functionsto separate fresh gas for inhalation from exhaled gas. The valve housing24 is provided with a breathing tube 26 for insertion in a patientsmonth. When desired, the breathing tube may be replaced with a face mask(not shown).

Attached to the valve housing 24 by means of a conduit 28 is amedicament nebulizer 30 for introducing medicament into the gas streamfor inhalation by the patient. Gas under pressure is provided foroperation of the nebulizer 30 through a hose or conduit 32 connecting tothe pressure control apparatus 20.

Pressure Control Apparatus The pressure control apparatus 20 is housedin a substantially cylindrical housing formed by two matingsubstantially cup-shaped housing members 36 and 38, as shown in FIGURE2. Disposed radially within the housing and separating the cup-shapedmembers 36 and 38 is a resilient diaphragm 40 provided with an annularrib 42. The annular rib 42 is seated in an annular groove providedtherefor in the end wall of the housing member 36 to provide a sealinggasket between the housing members 36 and 38. The housing members 36 and38 are held in compressive engagement with the diaphragm by screws (notshown) or other suitable means.

The diaphragm 40 divides the housing into two substantially cylindricalchambers 44 and 46. The chamber 46 communicates with the ambientatmosphere through a port 49 provided in the wall of the housing memberMounted in the chamber 44 is an apertured block 47 functioning, as willbe described subsequently, as a valve seat. An outlet port 48, seen bestin FIGURE 4, traversing the block 47 connects to the ambient atmospherethrough a conduit 50 seated in the block 47 and penetrating the wall ofthe housing member 36. A clapper valve 53 closes the conduit 50,permitting a passage of gas only out of the chamber 44, not into thechamber 44. This construction is best seen in FIGURE 4.

An inlet port 52 extends angularly through the block 47 to communicatewith a channel 5 4 through which a gas under pressure may be supplied tothe chamber 44. The housing member 36 is provided with a spigot 56providing the channel 54 for connection to a source of gas underpressure.

A. gate valve 58 operated by a ring-lever 60 is provided for restrictingthe gas flow into the inlet port 52. The ring-lever 60 girdles thespigot 56 and is rotatably seated thereon. A washer 62 held incompressive abutment with the ring-lever 69 by an elastomeric band 64,also seated on the spigot 56, provides a substantially air-tight seal toprevent leakage of gas around the ring-lever.

As best seen in FIGURE 9, the ring-lever 60 is provided with an annularcam surface 66 which engages a pin 68 traversing the wall of the spigot56 and carrying the gate valve 58. The pin 68 is held in compressiveengagement with the cam surface 66 by means of a spring 70 engaging theinternal wall of the spigot. A handle 72 secured to the ring-lever 60provides for manual rotation of the ringlever to adjust the position ofthe gate valve 58 so as to adjust the How of gas into the inlet port 52.

A spigot 78 integral with the housing member 36 pro vides for connectionof the conduit 22 to the pressure control apparatus. The conduit member22 communicates eventually with the lungs of a patient, forming a closedvolume with the chamber 44.

A slide valve plate 74 best seen in FIGURE 6, is provided in the chamber44 for closing selectively either the outlet port 48 communicating tothe ambient atmosphere or the inlet port 52 communicating to the sourceof gas under pressure. The valve plate 74 is pivotally mounted upon apin 79 secured to the housing member 36 with a lJ-shaped bracket 81.Depending upon the location of the valve plate 74, the pressure in thechamber 44 may either equal that of the ambient atmosphere, or begreater than that of the ambient atmosphere. A pressure gauge 76 isthreadedly connected to the housing member 36 for measuring the pressurein the chamber 44.

Traversing axially the chambers 44 and 46 is a rod 80 having an enlargedsubstantially square end portion 82 seated in a cylindrical bearingmember 84, in the base portion of the housing member 36. The oppositeend of the rod 80 projects through the base portion of the housingmember 38, the member 38 being provided with a bearing member 86 in thewall thereof for accommodating the rod 80.

The portion of the rod 80 traversing the chamber 44 has a diametergreater than the corresponding portion traversing the chamber 46,thereby providing for a shoulder 88 for engagement with the diaphragm40. The diaphragm 40 is secured to the rod 80 with a pair of washera 90,one seated upon the shoulder 88 on one side of the diaphragm and theother secured by a pin 92 traversing the rod 80 on the other side of thediaphragm 40'.

In response to pressure changes in the closed volume including thechamber 44, the rod 80 is urged to move axially by the diaphragm 40. Anaxial displacement of the diaphragm 40 is promoted by providing anannular arched portion 94 therein adjacent the cylindrical wall of thehousing 20, the arched portion 94 straightening as the diaphragm movesaxially. To obtain maximum effective pressure area for the diaphragm 40,a thin metallic or plastic disc 96 is placed on each side of thediaphragm, each disc 96 being sandwiched between one washer 90 and thediaphragm 40.

The axial motion of the rod 80 and diaphragm 40 is utilized to governthe motion of the valve plate 74 through a. novel toggle mechanism shownin FIGURES 4 and S. Slidably engaging the rod 80 within the chamber 44is a sleeve 98, the sleeve being seated upon the enlarged square endportion of the rod 80, as shown in FIGURE 5. Pivotally secured to thesleeve 98 are two oppositely directed, radially extending shafts 100which slant upwardly toward the diaphragm 40 from the sleeve 98. Thefree outer ends of the shafts 100 are journalled for reciprocatingmovement into L-shaped bracket members 104, there being one such bracketmember for each shaft 100. Each bracket member 104 is secured to thehousing member 36 by any suitable means.

A helical spring 108 extends around each shaft 100 compressivelyabutting the sleeve 98 at one end of the shaft 100 and the L-shapedbracket member 104 at the other end of the shaft 100. Due to the angulardisposition of the shafts 100, the springs 108 cooperate to urge thesleeve 98 and, as a consequence, the rod 80, towards the base of thechamber 44.

An actuator arm .110 projects radially from the sleeve 98 through a slot112 in the valve plate 74 to seat in an axially extending channel 114provided therefor in the block 47. The slot 112 in the valve plate 74 iselongated axially, to permit lost axial motion of the actuator arm 110within the valve plate 74.

The pressure control apparatus is depicted in the drawings at an instantwhen the pressure within both chambers 44 and 46 is that of the ambientatmosphere. If gas under pressure is delivered to the chamber 44 throughthe inlet port 52, the gas pressure within the chamber 44 will rise. Theincreasing gas pressure displaces the diaphragm 40 axially, so as toenlarge the chamber 44 and, as a consequence, the rod is drawn axiallyaway from the base of the chamber 44. The rod 80 carries with it thesleeve 98 of the toggle mechanism. As the sleeve 98 is carried axiallyin the chamber 44 away from the base thereof, the shafts are pivotedinto parallel alignment, while simultaneously the actuator arm traversesthe slot 112 of the valve plate 74. At the instant the toggle mechanismreaches the neutral or dead center position wherein the shafts 100 areparallel, the actuator arm engages the valve plate 74. The motion of theactuator arm 110 as the toggle mechanism approaches dead center is thuslost motion relative to the valve plate 74.

With continued rise in pressure, the springs 108 of the toggle mechanismdrive the sleeve 98 axially by a snap action along the rod 80 toward thediaphragm 40, where the sleeve 98 engages a stop 116 which limits theaxial motion thereof. The stop 116 is secured to the base of the housingmember 36 at such an elevation in the chamber 44 that when the sleeve 98engages the stop 116, the valve plate 74, driven by the actuator arm 110will cover the inlet port 52 in the block 47, thus shutting off theincoming gas.

Proper positioning of the valve plate 74 over the inlet port 52 isinsured by placing a stop 118 secured to the block 47 by a bracket 120for engaging the valve plate 74 as it covers the inlet port 52. Thevalve plate 74 is firmly seated against the block 47 by a leaf spring122, or the like, supported by the bracket 120.

As the valve plate is pivoted from a position covering the outlet port48, as shown in the drawings, to the new position covering the inletport 52, gas flows out of the closed volume including the chamber 44,through the outlet port 48, reducing the gas pressure within the chamber44 to atmospheric pressure, and, as will be described subsequently,permitting a patient undergoing treatment to exhale. The fallingpressure in the chamber 44 returns the diaphragm 40 to its equilibriumposition, but does not reset the toggle mechanism. The sleeve 98 remainsin abutment with the washer 90 of the diaphragm assembly.

In order to reset the toggle mechanism, the patient must inhale briefly,closing the clapper valve 53 to close the conduit 50 and lowering thepressure in the chamber 44 below atmospheric pressure. This causes thediaphragm 40 to move axially, driving the toggle mechanism toward thebase of the chamber 44. As the toggle mechanism approaches the deadcenter position, the actuator arm 110 crosses the slot 112 in lostmotion in the valve plate 74 and, as the toggle mechanism passes thedead center position, the springs 108 snap the sleeve 98 to the base ofthe chamber 44, moving the valve plate 74 to the position covering theoutlet 48 in the block 47. Gas flows in the inlet port 52 and a newinhalation cycle is thereby initiated.

It is desirable that the inhalation cycle be initiated with a minimum ofeffort on the part of the patient. Accord ngly, the springs 108 in thetoggle mechanism are made ust strong enough that they properly positionthe valve plate 74. The reduced pressure in the chamber 44 necessary toactuate the toggle mechanism is then minimized, so as to be readilycreated by a patient. The control apparatus herein disclosed is a demandresponsive mechanism, in that the inhalation cycle is started only afterthe patient demands air.

A fiat spring 124, shown in FIGURES 2 and 7, is employed for controllingthe maximum inhalation pressure developed in the chamber 44. A threadedannular flange 126, concentric with the rod 80, is provided on the endof the housing member 38. Threadedly connected to the flange 126 is acap member 128, carrying a disc 130, to which is secured the flat spring124. The cap member 128 is adjusted by rotation, so that the flat spring124 engages the rod 80 at substantially the instant the toggle mechanismis driven to the neutral point during the inhalation cycle. Clearly, inorder to terminate the inhalation cycle, the diaphragm 40 must firstovercome the restraining or biasing force of the flat spring 124 beforedriving the toggle mechanism away from the neutral position. The maximumpressure obtained in the chamber 44 is determined by the resistanceoffered by the spring 124.

By rotating the cap member 128 so as to move the spring 124 closer tothe diaphragm 40, the restraining force exerted by the spring 124 can beincreased, since it becomes necessary to displace the spring 124 agreater distance to terminate the inhalation cycle. The cap member 128thus represents a pressure adjustment. A pointer 132, integral with thecap member 128, cooperates with suitable indicia (not shown) on thehousing member 38 to provide a means of presetting the spring 124 for aparticular maximum pressure value.

For occasions when the patient undergoing treatment has apnea and istherefore unable to initiate the inhalation cycle, a manual actuator isprovided for starting the inhalation cycle. Seated within a hollowcylindrical projection 134 in the cap 128 is a button 136 loaded with ahelical spring 138, compressively engaging the disc 1311 at one endthereof and the button 136 at the other end thereof. This structure isshown in FIGURE 2.

Projecting into the cap member 128 is a shaft 14% of diameter smallerthan the rod 80 slidably seated in the button 136. As the button 136 isdepressed, the shaft 149 is thrust through a small aperture 142 placedtherefor in the center of the fiat spring 124, to engage the rod 8t), soas to drive the rod 80 and the diaphragm 40 axially toward the base ofthe chamber 44. This resets the toggle mechanism, positioning the valveplate 7; over the outlet port 48 and opening the gas inlet port 52 so asto initiate an inhalation cycle.

In the event the button 136 is not released, an override spring 144 isprovided, allowing the pressure control apparatus to operate as aresuscitator. The override spring 144 is strong in comparison to thetoggle mechanism, but weak as compared to the fiat spring 124. Afterinitiation of the inhalation cycle, the override spring 144 yields tothe axial movement of the diaphragm 4t} and the rod 80, allowing thetoggle mechanism to operate the valve 74. After the termination of oneinhalation cycle, a new inhalation cycle is initiated as soon as the gaspressure in the chamber 44 drops sufficiently that the spring 144 canreset the toggle mechanism. Since the spring 144 is weak in comparisonto the fiat spring 12-1, the maximum positive pressure developed duringresuscitation is not significantly greater than would occur duringnormal demand responsive operation.

The Exlialazion Valve Assembly The pressure regulator supplies anintermittent gas pressure of variable amplitude to the conduit 22 whichcommunicates with the valve housing 24. As best seen in FIGURE 3, thevalve housing is formed with two mating substantially conical members152 and 154, separated by a flexible diaphragm 156. The diaphragm 156 isprovided with an annular rib 158 at the perimeter thereof which seats ina complementary annular groove in the Wall of the conical member 154.The diaphragm serves as a sealing gasket between the two members 152 and154 which are held in compressive engagement therewith by releasableclasps 162.

The conical housing member 152 is provided with a spigot 164 forconnection to the conduit 22 communicating with the pressure regulatorapparatus and the conical housing member 154 is provided with a spigot166 for connection to the breathing tube 26 leading to the pa.- tientslungs. The diaphragm 156 therebetween provides for a check-valve betweenthe housing members 152 and 154 resisting a flow of gas from thebreathing tube to the conduit 22; but offering only small resistance toa flow of gas from the conduit 22 to the breathing tube.

The diaphragm 156 is provided with an annular flange 168, the diameterof the flange 163 being approximately half the diameter of the rib 158.The flange 168 projects into the conical housing member [54 to seat acircular check-valve 170. The check-valve 178 has a stem 172 projectingnormally from the center thereof through an aperture in the center ofthe diaphragm 156. An annular channel 174 in the stem 172 engages thecentral portion of the diaphragm as a means of securing the valve to thediaphragm. A pair of apertures 176 are placed in the diaphragm 156intermediate the annular flange 168 and the stem 172 to provide for apassage of gas through the diaphragm.

When there is a pressure diiierential across the diaphragm such that thepressure in the conical housing member 154 is greater than the pressurein the housing member 152, the valve 171) seats firmly= upon the flange163 and no air can pass through the diaphragm. When the pressurediilercntial is reversed, the valve 170 is displaced from the flange 168to permit gas to flow through the diaphragm.

intermediate the annular flange 168 and the annular rib 158, thediaphragm 156 is provided with an annular arched portion 177 whichpermits an axial displacement of the diaphragm in response to a pressuredifferential across the diaphragm. The conical housing member 154 isprovided with an annular wall or flange 178 engaging the diaphragm 156intermediate the annular arched portion 177 and the annular flange 168of the diaphragm. The annular flange 178 of the housing member 154cooperates with the arched portion 177 of the diaphragm to provide anannular channel 189 in the conical housing member 154. The annularchannel 181 communicates with an exhalation port 182 integral with theconical housing member 154.

When a pressure differential develops across the diaphragm 1.56 suchthat the pressure within the housing member 152 is greater than or equalto the pressure in the housing member 154 and greater than the pressurein the annular channel 189, the diaphragm is driven axially toward theannular flange 178 of the housing member 154 to close 011 the channel139 therein, and hence to close oil the exhalation port 182. When thepressure differential is reversed so that the pressure in the housingmember 154 or the channel 183 is greater than that in the housing member152, the diaphragm 156 is displaced axially away from the annular flange178 to open the annular channel 180. This permits gas to be exhaled intothe exhalation port 132. The port 182 connects to a low resistanceexhalation chcclevalve 184, which prevents inhalation through the port182.

The valve assembly in the valve housing 24, permits a passage of gas toa patients lungs isolating the exhalation port during the inhalationcycle. During the exhalation cycle, exhaled gases are vented directly tothe ambient atmosphere through the exhalation port. In this manner. thevalve assembly functions to separate exhalation and inhalation gases.

The Medicament Nebuiizer Assembly The medicament nebulizer 30 connectsto the conical valve housing member 154 through a conduit 28. As shownin FIGURE 8, the medicament nebulizer comprises a vertically orientedsubstantially cylindrical housing 186, in which is mounted a verticallyextending hollow tube 188. The hollow tube 188 cooperates with a gasinlet jet 190, to provide a conventional atomizer for vaporizing amedicament placed in the housing. The gas jet 190 is supplied with gasunder pressure through the hose 32 connecting to a spigot 192 threadedlyconnected to the housing member 36 of the pressure control apparatus.Through an aperture 194 in the housing member 36, the hose 32 connectsdirectly to the incoming gas regulated by the gate valve 58.

As a means of conserving medicament, a pressure sensitive hose clampassembly, as shown in FIGURE 10, is utilized to regulate the gas flow tothe nebulizer 30 in response to pressure variations produced by thepressure control apparatus.

The hose clamp assembly includes a shallow cylindrical housing 196having a base portion 198 and enclosed by a top portion 200. A flexiblediaphragm 202 extending radially in the housing 196 divides the housinginto two chambers 204 and 206. The diaphragm 202 is provided with anannular flange 208 along the perimeter thereof which is secured to thewall of the housing 196 by a suitable means. An aperture 210 traversesthe wall of the housing 196 to the chamber 206, so as to maintain thechamber 206 at atmospheric pressure.

The diaphragm 202 is adapted to move axially in the housing 196 byproviding an annular arch 212 therein. A thin metal or plastic disc 214engages the central portion of the diaphragm 202 within the chamber 206,to prevent bowing or stretching of the diaphragm.

The legs 216 of a U-shaped bridge member 218 encircling the hose 32slidably penetrate the top 200 of the housing 196. The legs 216 aresecured in any suitable manner to the disc 214. A helical spring 220encircles the legs 216 within the chamber 206, compressively en gagingthe disc 214 at one end thereof and the top 200 of the housing 196 atthe other end thereof.

A bolt 222. threadedly engages the arcuate portion of the U-shapedbridge member 218. The bolt 222 is provided with a tapered tip 224 whichpinches the hose 32. When the pressure in both chambers 204 and 206 isthat of the ambient atmosphere, the spring 222 is sutficiently strong tocause the tapered tip 224 to fully close the flexible hose 32.

Through a conduit or hose 226, the chamber 204 of the hose clampassembly communicates with the conduit 22. When the pressure in theconduit 22 is substantially that of the atmosphere, the hose 32 isclosed and no medicament is vaporized. As the pressure in the conduit 22rises during the inhalation cycle of the pressure control apparatus, thediaphragm 202 in the hose clamp assembly is displaced axially againstthe spring 220 actuating the bridge member 218 to open the hose 32. Theopening in the hose 32 may be adjusted by rotating the bolt 222. Thispermits vaporization of medicament, which travels into the breathingtube 26 through the valve housing member 154. At the termination of theinhalation cycle, the pressure in the conduit 22 returns to atmosphericpressure and, as a consequence, the flexible hose 32 is pinched closedand vaporization of the medicament ceases.

Mode of Operation The breathing tube 26 is provided with a resilient endplate 230 adapted for insertion in a patients mouth between the lips andteeth. The patient retains the breathing tube by biting on a pair offlanges 232 projecting from the end plate 230.

As the patient undergoing treatment first demands air, the clapper valve53 closes the outlet port 48 and the gas pressure in the chamber 44decreases. The diaphragm 40 actuates the toggle mechanism to shift theposition of the valve plate 74 opening the gas inlet port 52 and closingthe gas outlet port 48.

A gas under pressure flows to the chamber 44 through the inlet port 52and thence through the conduit 22 to the patient's lungs, forcefullyfilling the lungs. With increasing gas pressure in the conduit 22, thehose clamp assembly is operated to open the hose 32 leading to thenebulizer 30. Vaporized medicament is released to the gas stream,flowing therewith into the lungs of the patient.

When the gas pressure in the lungs, conduit 22, and chamber 44 reachesthe maximum pressure as determined by the setting of the cap 128, whichpositions the flat spring 124, the toggle mechanism is actuated to shiftthe position of the valve plate 74, closing the gas inlet port 52 andopening the outlet port 48. The high gas pressure in the chamber 44forces open the clapper valve 53 and gas flows out of the chamber 44 andthe conduit 22 reducing the gas pressure therein to substantiallyatmospheric pressure.

The reduced gas pressure in the conduit 22 operates the hose clampassembly to close off the hose 32, thus cutting off the supply ofmedicament to the lungs. Simultaneously, the high gas pressure in thelungs operates the diaphragm 156 in the valve housing 24 so as to openthe exhalation port 182 and gas is permitted to flow out of the lungs innormal exhalation.

As soon as the patient again demands air by attempting to inhale, thecycle described above begins anew.

The time duration of the inhalation cycle is controlled by regulatingthe flow of gas into the chamber 44. The flow of gas is increased ordecreased by adjusting the gate valve 58 with the handle 72 projectingfrom the pressure control apparatus. The maximum pressure developed inthe patients lungs is regulated by adjusting the cap 128 positioning theflat spring 124, which biases the movement of the diaphragm 40. Theamount of medicament delivered to the gas stream by the nebulizer may beregulated by adjusting the bolt 222 in the hose clamp assembly.

The patient may exhale at any time during the inhalation cycle bydeveloping a lung pressure greater than the pressure in the conduit 22.This operates the valve assembly in the housing 24 to close 01f theconduit 22 and open the exhalation port 182. As the patient exhales, thechamber 44 will rapidly build up to maximum pressure actuating thetoggle mechanism to open the outlet port 48. The pressure controlapparatus will thus be in proper position to initiate a new inhalationcycle when the patient next attempts to inhale.

It is highly desirable in a device such as this that provision be madefor sterilizing the components subject to contamination. It is apparentthat, in the present device, only the breathing tube and exhalationvalve assembly are subject to contamination from the patients breathsince the pressure control apparatus is isolated from the patientsexhalation breath by the operation of the exhalation valve assembly.

The releasable clasps 162 of the valve housing 24 provide for quickdisassembly of the valve housing so that the housing member 154, thediaphragm 156, the checkvalve 170, the breathing tube 26, and theexhalation valve 184 may all be separated to facilitate sterilization.The housing member 152 of the valve housing is not subject tocontamination.

Although the preferred embodiment of the device has been described, itwill be understood that within the purview of this invention variouschanges may be made in the form, details, proportion and arrangement ofparts, the combination thereof and mode of operation, which generallystated consists in a device capable of carrying out the objects setforth, as disclosed and defined in the appended claims.

Having thus described my invention, I claim:

1. A device operable from a source of gas under pressure for use in thetreatment of patients having pulmonary disorders, said devicecomprising, in combination, pressure responsive means connected to thesource of gas under pressure for regulating the flow of gas therefrom, aconduit communicating with said pressure responsive means andterminating in an adapter for fitting the mouth of a patient forconveying gas to the lungs of the patient, said pressure responsivemeans operating to permit a flow of gas from said source to said conduitin response to a gas pressure less than that of the ambient atmospherecreated by inhalation demand of the patient and operating to stop theHow of gas from said source to said conduit while simultaneouslyconnecting said conduit to the ambient atmosphere when the gas pressurein said conduit obtains a predetermined maximum value relative to thatof the ambient atmosphere, and pressure sensitive valve means positionedbetween said adapter and said conduit for closing said conduit andsimultaneously providing a passage from said adapter to the ambientatmosphere whenever the gas pressure in said adapter exceeds the gaspressure in said conduit.

2. A device operable from a source of gas under pressure for use in thetreatment of patients having pulmonary diseases, said device comprising,in combination, a pressure regulator connected to the source of gasunder pressure for regulating the flow of gas therefrom to establish abreathing cycle, an adapter for delivering the gas to a patient, aconduit connecting said pressure regllator with said adapter, exhalationvalve means responsive to a gas pressure ditterential between saidconduit and said adapter interposed therebetween, said exhalation valvemeans providing a first passage between said adapter and said conduitand a second passage between said adapter and the ambient atmosphere,said valve means having two positions, a first position opening saidfirst passage while closing said second passage, and a second positionclosing said first passage while opening said second passage, anebulizer operating from the source of gas under pressure supplying avaporized medicament to said conduit, and means responsive to the gaspressure in said conduit for regulating the flow of gas from said sourceto said nebulizer, the construction and arrangement being such that gasis permitted to flow from said source to said nebulizer to delivervaporized medicament to said conduit only when the gas pressure in saidconduit exceeds a predetermined value above that of the ambientatmosphere.

3. A device operable from a source of gas under pressure for use in thetreatment of patients having plumonary diseases, said device comprising,in combination, control means connected to the source of gas underpressure for regulating the flow of gas therefrom to establish abreathing cycle, conduit means communicating with said control means forconveying gas therefrom to the lungs of a patient, nebulizer meanscommunicating between the source of gas under pressure and the conduitmeans for supplying a vaporized medicament to the conduit means, meansresponsive to the gas pressure in said conduit means for regulating thenebulizer means such that gas is permitted to flow from said source tosaid nebulizer to deliver vaporized medicament to said conduit only whenthe gas pressure in said conduit exceeds a predetermined value abovethat of the ambient atmosphere, and valve means providing for exhalationby the patient to the ambient atmosphere and preventing exhalation bythe patient into said conduit means.

4. A pressure control apparatus for regulating the flow of gas from asource of gas under pressure into a closed volume, said apparatusincluding a housing defining a gas receiving chamber communicating withand forming a part of said closed volume, pressure sensitive meanscommunicating with said chamber, means providing a gas inlet to saidchamber communicating with the source of gas under pressure, meansproviding a gas outlet from said chamber communicating with the ambientatmosphere, a valve member, disposed in said chamber for alternatelycovering the gas inlet and the gas outlet, valve operating meansresponsive to said pressure sensitive means for actuating said valvemember so as to close the gas inlet when the gas pressure in saidchamber obtains a predetermined maximum value and to close the gasoutlet when the gas pressure in said chamber obtains a predeterminedminimum value, and yielding means for manually actuating said valveoperating means so as to close the gas outlet when the as pressure insaid chamber is greater than the minimum valve, said yielding meansyielding when the gas pressure in said chamber exceeds a predeterminedmaximum value.

5. A pressure control apparatus for regulating the flow of gas from asource of gas under pressure into a closed volume, said apparatusincluding a housing defining a gas receiving chamber communicating withand forming a part of said closed volume, pressure sensitive meanscommunicating with said chamber, means providing a gas inlet to saidchamber communicating with the source of gas under pressure, meansproviding a gas outlet from said chamber communicating with the ambientatmosphere, pressure operated valve means disposed in said gas outletfor closing the gas outlet when the gas pressure in said chamber isbelow that of the ambient atmosphere, a pivotally mounted valve memberfor closing alternately the gas inlet and gas outlet, and valveoperating means responsive to said pressure sensitive means for pivotingsaid valve member between the gas inlet and the gas outlet so as toclose the gas inlet, opening the gas outlet when the gas pressure insaid chamber obtains a predetermined value above atmospheric pressureand to close the gas outlet opening the gas inlet when the gas pressurein said chamber obtains a predetermined value below atmosphericpressure.

6. A pressure control apparatus for regulating the flow of gas from asource of gas under pressure into a closed volume, said apparatusincluding a housing defining a gas receiving chamber communicating withand forming a part of said closed volume, a pressure sensitive diaphagmdisposed in one wall of said chamber, a rod carried by said diaphragmtraversing said chamber, means providing a gas inlet to said chambercommunicating with the gas under pressure, means providing a gas outletfrom said chamber communicating with the ambient atmosphere, a pivotallymounted valve plate having a slot therein, said valve plate closingalternately the gas inlet and the gas outlet, reciprocably mounted meansoperated by said diaphragm for positioning said valve means, saidreciprocably mounted means comprising a toggle mechanism including asleeve slidably mounted on said rod for reciprocating motion thereonabout the dead center position of said toggle assembly, resilient meansbiasing the toggle mechanism away from dead center so as to urge saidsleeve to occupy one of two extreme positions on said rod, and anactuator arm carried by said sleeve projecting into the slot in saidvalve plate for pivoting the valve plate between positions covering thegas inlet and the gas outlet, the slot in said valve plate providing forlost motion of the actuator arm therein whereby the actuator arm pivotsthe valve plate only as the sleeve carrying the actuator arm moves awayfrom the dead center position of the toggle assembly.

7. A pressure control apparatus for regulating the flow of gas from asource of gas under pressure into a closed volume, said apparatusincluding a housing defining a gas receiving chamber communicating withsaid forming a part of said closed volume, pressure sensitive meanscommunicating with said chamber, means providing a gas inlet to saidchamber communicating with the source of gas under pressure, meansproviding a gas outlet from said chamber communicating with the ambientatmosphere, a single valve element for closing alternately the gas inletand the gas outlet, and valve operating means powered by said pressuresensitive means for shifting the position of the valve elementalternately between the gas inlet and the gas outlet, said valveoperating means including a lost motion mechanism whereby limited lostmotion of the pressure sensitive means is permitted prior to actuationof said valve means.

8. The combination with a medicament nebulizer 0peratcd by a source ofgas under pressure connected thereto by a flexible hose, said medicamentnebulizer delivering gas to a gas stream of variable pressure, of meansresponsive to the gas pressure of said gas stream for regulating theoperation of the nebulizer, said means including a housing defining agas receiving chamber, means connecting said chamber with the gasstream, pressure sensitive means communicating with said chamber, andhose pinching means operated by said pressure sensitive means forpinching said hose an amount determined by the gas pressure in the gasstream.

9. A device operable from a source of gas under pressure for use in thetreatment of patients having pulmonary diseases, said device comprising,in combination, control means connected to the source of gas underpressure for regulating the flow of gas therefrom to establish abreathing cycle, conduit means communicating with said control means forconveying gas therefrom to the lungs of a patient, nebulizer meanscommunicating between the source of gas under pressure and said conduitmeans for supplying a vaporized medicament to said conduit means, meansresponsive to the gas pressure in said conduit means for regulating thenebulizer means such that gas is permitted to flow from said source tosaid nebulizer to deliver vaporized medicament to said conduit only whenthe gas pressure in said conduit exceeds a predetermined value abovethat of the ambient atmosphere, and valve means providing for exhalationby the patient to the ambient atmosphere, said valve means including ahousing partitioned by a flexible diaphragm disposed in said conduit,said diaphragm having an aperture located centrally therein, pressuresensitive valve means secured to said diaphragm for closing saidaperture when the gas pressure in the patients lungs exceeds thatdelivered by said pressure regulating means and for opening saidaperture when the pressure differential is reversed, means asso ciatedwith said housing providing an exhalation passage from said conduit tothe ambient atmosphere intermediate the patients lungs and saiddiaphragm, and means cooperating with said diaphragm to close saidexhalation passage when the pressure delivered by said pressureregulating means exceeds that in the patients lungs.

10. A pressure control apparatus for regulating the flow of gas from asource of gas under pressure into a closed volume, said apparatusincluding a housing defining a gas receiving chamber communicating withand forming a part of said closed volume, pressure sensitive meanscommunicating with said chamber and with the ambient atmosphere, meansproviding a gas inlet to said chamber communicating with the source ofgas under pressure, means providing a gas outlet from said chambercommunicating with the ambient atmosphere, a valve member foralternately covering the gas inlet and the gas outlet, means responsiveto said pressure sensitive means for operating said valve member so asto close the gas inlet when the gas pressure in said chamber obtains apredetermined maximum value relative to that of the ambient atmosphereand to close the gas outlet when the gas pressure in said chamberobtains a predetermined minimum value, and means for regulating the timerequired for the gas pressure in said chamber to reach the predeterminedmaximum value, said means including a gate valve, an annular ringencircling said gas inlet, radially disposed pin means slidablypenetrating said annular ring and supporting said gate valve in saidannular ring for reciprocal movement across said inlet between oppositeextreme positions, said gate valve fully closing said inlet in oneextreme position and opening said inlet in the opposite position,annular cam means rotatably journalled on said annular ring and havingan internal cam surface of varying radius engaging said pin means foradjustably moving said gate valve across said inlet, and resilient meansbiasing said pin means against said cam surface.

11. A device operable from a source of breathing gas under pressure foruse in the treatment of patients having pulmonary diseases, said devicecomprising, in combination, control means connected to the source of gasunder pressure for regulating the flow of gas therefrom to establish abreathing cycle, conduit means communicating with said control means forconveying gas therefrom to the lungs of a patient, said conduit meansexcluding atmospheric gases from the breathing gas, nebulizer meanscommunicating directly between the source of gas under pressure and theconduit means for supplying the vaporized medicament to the breathinggas in said conduit means, and means responsive to the gas pressure insaid conduit means for regulating the nebulizer means such that gas ispermitted to flow from said source to said nebulizer to delivervaporized medicament to said conduit only when the gas pressure in saidconduit exceeds a predetermined value above that of the ambientatmosphere.

References Cited in the file of this patent UNITED STATES PATENTS Re.24,193 Emerson Aug. 7, 1956 2,268,172 Sinnett Dec. 30, 1941 2,391,877Cahan Jan. 1, 1946 2,473,518 Garrard June 21, 1949 2,535,844 EmersonDec. 26, 1950 2,593,046 McKee Apr. 15, 1952 2,598,525 Fox May 27, 19522,617,414 Hol lman Nov. 11, 1952 2,693,178 Gilroy Nov. 2, 1954 2,774,346Halliburton Dec. 18, 1956 2,814,291 Holmes Nov. 26, 1957 2,843,120Thauer et al. July 15, 1958 2,908,270 Stanton Oct. 13, 1959 FOREIGNPATENTS 1,063,122 France Dec. 16, 1953 77.740 Denmark June 28, 1954

4. A PRESSURE CONTROL APPARATUS FOR REGULATING THE FLOW OF GAS FROM ASOURCE OF GAS UNDER PRESSURE INTO A CLOSED VOLUME, SAID APPARATUSINCLUDING A HOUSING DEFINING A GAS RECEIVING CHAMBER COMMUNICATING WITHAND FORMING A PART OF SAID CLOSED VOLUME, PRESSURE SENSITIVE MEANSCOMMUNICATING WITH SAID CHAMBER, MEANS PROVIDING A GAS INLET TO SAIDCHAMBER COMMUNICATING WITH THE SOURCE OF GAS UNDER PRESSURE, MEANSPROVIDING A GAS OUTLET FROM SAID CHAMBER COMMUNICATING WITH THE AMBIENTATMOSPHERE, A VALVE MEMBER, DISPOSED IN SAID CHAMBER FOR ALTERNATELYCOVERING THE GAS INLET AND THE GAS OUTLET, VALVE OPERATING MEANSRESPONSIVE TO SAID PRESSURE SENSITIVE MEANS FOR ACTUATING SAID VALVEMEMBER SO AS TO CLOSE THE GAS INLET WHEN THE GAS PRESSURE IN SAIDCHAMBER OBTAINS A PREDETERMINED MAXIMUM VALUE AND TO CLOSE THE GASOUTLET WHEN THE GAS PRESSURE IN SAID CHAMBER OBTAINS A PREDETERMINEDMINIMUM VALUE, AND YIELDING MEANS FOR MANUALLY ACTUATING SAID VALVEOPERATING MEANS SO AS TO CLOSE THE GAS OUTLET WHEN THE GAS PRESSURE INSAID CHAMBER IS GREATER THAN THE MINIMUM VALVE, SAID YIELDING MEANSYIELDING WHEN THE GAS PRESSURE IN SAID CHAMBER EXCEEDS A PREDETERMINEDMAXIMUM VALUE.